不同液体治疗方案对腹腔镜结肠手术患者炎性因子及术后康复的影响

Influences of different liquid treatment schemes on inflammatory factors and postoperative rehabilitation of patients with laparoscopic colon surgery

目的探析不同液体治疗方案对腹腔镜结肠手术患者炎性因子及术后康复的效果。方法选取2019年1月至2019年8月营口市中西医结合医院收治的腹腔镜结肠手术患者84例,按随机数字表法分为对照组和试验组各42例。对照组采用限制性输入治疗,试验组采用目标导向液体治疗,比较2组炎性细胞因子[白细胞介素6(Interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)]改善情况和住院时间、液体总量、肠道恢复情况,比较各个时间点心率(HR)、平均动脉压(MAP)、血氧饱和度(pulse oxygen saturation,SpO2)。结果治疗前,2组IL-6、TNF-α水平差异无统计学意义(P>0.05);治疗后,2组IL-6、TNF-α水平均低于治疗前,试验组IL-6、TNF-α水平明显低于对照组,差异有统计学意义(P<0.05)。试验组住院时间和肠道恢复时间短于对照组,液体总量少于对照组,差异有统计学意义(P<0.05)。2组HR、MAP、SpO2均有所波动,试验组HR、MAP、SpO2波动范围小,优于对照组,差异有统计学意义(P<0.05)。结论腹腔镜结肠手术患者围手术期进行目标导向液体治疗能够加快恢复进程,降低炎症反应,具有重要临床价值。

Objective To explore the effects of different liquid treatments on inflammatory factors and postoperative rehabilitation of patients with laparoscopic colon surgery.Methods A total of 84 patients who were admitted to our hospital from January 2019 to August 2019 and underwent laparoscopic colon surgery were selected.They were divided into control group and experimental group by random number table,with 42 cases in each group.The control group was treated with restrictive infusion therapy,while the experimental group was treated with goaloriented fluid therapy.The improvement of inflammatory factors,the length of hospitalization,total fluid volume and intestinal recovery in the two groups were compared.In addition,HR,MAP,and SpO2 were compared at various time points.Results By comparing the inflammatory factors between the two groups,it was found that there were no differences in IL-6 and TNF-αbetween the two groups before treatment(P>0.05).After the treatment,the inflammatory factors in two groups were improved,and factors in the experimental group were significantly lower than those in the control group.The difference was significant(P<0.05).According to the hospitalization time,total fluid volume,and intestinal recovery of the two groups,the expulsion time and total fluid volume of the experimental group were obviously superior to those of the control group,and the hospitalization time was effectively shortened.The differences were significant(P<0.05).Through the comparison of HR,MAP,SpO2 between the two groups at various time points,it was found that there were significant differences in HR,MAP and SpO2 between control group and experimental group(P<0.05).Conclusion For patients with laparoscopic colon surgery,goal-directed fluid therapy during the perioperative period can speed up their recovery process and reduce inflammation,which has important clinical significance.